ABSTRACT
RESUMEN Introducción: el Tisuacryl es un biomaterial empleado en la cirugía general y bucal, así como en el tratamiento de la estomatitis aftosa, considerada un proceso multifactorial y actualmente la enfermedad ulcerosa más común de la cavidad oral. Objetivo: determinar la efectividad del Tisuacryl con respecto a la terapia convencional en el tratamiento de la estomatitis aftosa en Consolación del Sur, Pinar del Río, en el período comprendido entre septiembre 2018 y marzo 2020. Métodos: se realizó un estudio observacional analítico de casos y controles a 90 pacientes con estomatitis aftosa en Consolación del Sur, Pinar del Río, en el período comprendido entre septiembre 2018 y marzo 2020. La información se obtuvo de las historias clínicas individuales de Periodoncia al obtener el consentimiento oral y escrito de los pacientes o sus tutores. Los resultados se obtuvieron por análisis estadístico que incluyó el porciento y la prueba no paramétrica de Cochran Q. Resultados: predominó el sexo femenino y el grupo etario de 10 a 19 años para el 46,7 % en grupo estudio y el 42,2 % en grupo control; la disminución del dolor y la cicatrización iniciaron en el mayor número de pacientes a las 72 horas de tratamiento con Tisuacryl para el 91,1 % y el 55,6 % respectivamente; a los cinco días de aplicación del medicamento la totalidad de ellos estaban asintomáticos y casi todas las aftas bucales cicatrizadas. Conclusiones: las lesiones aftosas en la cavidad bucal evolucionaron satisfactoriamente con la aplicación del Tisuacryl al ser esta una alternativa efectiva de tratamiento en comparación con la terapia convencional.
ABSTRACT Introduction: Tisuacryl is a biomaterial used in general and oral surgery, as well as in the treatment of aphthous stomatitis, considered a multifactorial process and currently the most common ulcerative disease of the oral cavity. Objective: to determine the effectiveness of Tisuacryl with respect to conventional therapy in the treatment of aphthous stomatitis in Consolación del Sur, Pinar del Río, in the period from September 2018 to March 2020. Methods: an analytical observational case-control study was conducted on 90 patients with aphthous stomatitis in Consolación del Sur, Pinar del Río, in the period from September 2018 to March 2020. Information was obtained from individual Periodontics medical records by obtaining oral and written consent from patients or their guardians. Results were obtained by statistical analysis including percent and Cochran Q nonparametric test. Results: female sex and age group from 10 to 19 years old predominated for 46,7 % in the study group and 42,2 % in the control group; the decrease of pain and healing started in most patients 72 hours after treatment with Tisuacryl for 91,1 % and 55,6 % respectively; being five days after application of the drug all of them asymptomatic and almost all the oral aphthae healed. Conclusions: aphthous lesions in the oral cavity evolved satisfactorily with the application of Tisuacryl being an effective treatment alternative in comparison with conventional therapy.
ABSTRACT
RESUMEN El objetivo de este estudio fue comparar el tiempo de cicatrización entre N-butil cianocrilato (NBC) y ácido poliglicólico (AC) sobre el cierre tisular en caninos sometidos a operaciones de esterilización. Se realizó un estudio observacional, comparativo y descriptivo sobre una población de 80 perros (Canis familiaris) vivos. Los animales se dividieron en cuatro grupos de 20 perros cada uno según sexo y material de sutura, así: primero grupo, hembras que recibieron NBC; segundo grupo, machos y NBC; tercero grupo, hembras y AC como medio de sutura en piel y cuarto grupo, machos y AC. La técnica quirúrgica en hembras fue oforosalpingohisterectomia y en machos orquiectomia. El tiempo de cierre fue estadísticamente (p < 0,05) menor en los grupos de machos y hembras con el adhesivo NBC comparado con los dos grupos tratados con AC. Se concluye que el NBC es un material seguro y eficaz como medio de fijación tisular en ambas técnicas quirúrgicas que disminuye los días de cierre y recuperación.
ABSTRACT The aim of this study was to compare N-butyl cyanoacrylate (NBC) and polyglycolic acid (AC) in tissue closure in canines subjected to sterilization operations. An observational, comparative and descriptive study was conducted in a population of 80 living dogs (Canis familiaris). The animals were divided into 4 groups of 20 dogs each, according to gender and suture material: the first group consisted of females that received NBC; the second group consisted of males that received NBC; the third group consisted of females that received AC as skin suture; and the fourth group was formed by males that received AC. The surgical technique in females was salpingo-oophorectomy, and in males it was orchiectomy. The closure time was statistically (p < 0.05) lower in the male and female groups with the NBC adhesive in comparison to the two groups treated with AC. It was concluded that NBC is a safe and effective material for tissue fixation in both surgical techniques, decreasing times of closure and recovery.
ABSTRACT
Objetivo: Estimar a custo-efetividade do n-butil-cianoacrilato (NBCA) para fixação de telas em pacientes submetidos a hernioplastias inguinais por reparo aberto ou laparoscópico, sob a perspectiva da Saúde Suplementar do Brasil. Métodos: Foi elaborado modelo analítico de decisão para estimar a razão de custo efetividade incremental (RCEI) em horizonte de tempo de um ano após procedimento cirúrgico com o uso do adesivo sintético versus técnicas tradicionais de fixação (sutura e grampos). Alternativamente, o uso de NBCA foi comparado à cola de fibrina. Os desfechos clínicos avaliados foram incidência de dor aguda e crônica. A estimativa de custos médicos diretos totais para as diferentes abordagens cirúrgicas e terapia da dor foi elaborada a partir da opinião de especialistas e coletadas em bases de dados secundárias. Resultados: A RCEI obtida através do modelo evidenciou economia substancial de recursos financeiros relacionada ao uso de NBCA de aproximadamente R$ 2.800 por procedimento após reparo laparoscópico e R$ 60 reais por procedimento para reparo aberto, resultados direcionados majoritariamente pela menor tendência de dor (efetividade incremental de 21,74% em termos de dor evitada) versus métodos de fixação tradicional. No cenário alternativo, no qual comparou-se NBCA com a cola biológica (adesivo de fibrina), atingiu-se economia financeira com nível de efetividade equivalente do ponto de vista estatístico entre os comparadores. Conclusão: Pode-se atribuir que o uso de NBCA para fixação de telas em cirurgias de reparo de hérnia inguinal constitui alternativa segura, efetiva e viável economicamente, quando comparado tanto a técnicas de fixação tradicionais como à cola biológica.
Objective: To estimate the cost-effectiveness of n-butyl-cyanoacrylate (NBCA) for mesh fixation in patients undergoing inguinal hernia repair by open or laparoscopic methods, from the perspective of the Brazilian supplementary health sector. Methods: A decision model was developed to estimate the incremental cost-effectiveness ratio (ICER) in time horizon of one year after surgery with the use of synthetic adhesive versus traditional fixation techniques (suture and staples). Alternatively, the use of NBCA was compared to the fibrin glue. Clinical outcomes applied to the model were incidence of acute and chronic pain. The estimation of total direct medical costs for surgical approach and pain therapy was developed based on experts' opinions and collected from secondary databases. Results: The ICER obtained through the model indicated substantial savings of financial resources related to the use of NBCA of approximately 2,800 BRL per procedure after laparoscopic repair and 60 BRL per procedure for open repair, results primarily due to the lower tendency of pain (incremental effectiveness of 21.74% in terms of avoided pain) versus traditional fixation methods. In the alternative scenario, which compared NBCA with biological glue (fibrin glue), it was achieved financial savings, with statistically equivalent level of effectiveness among the comparators. Conclusion: The use of NBCA for mesh fixation in inguinal hernia repair surgery is a safe, effective and feasible alternative from an economic point of view, when compared to both traditional fixation techniques as the biological glue.